Strabismus surgery dosage.

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Provides mm of recession or resection of extraocular muscles for given magnitude of strabismus (esotropia, exotropia, hypertropia). These are for educational / informational purposes. Bibliography follows the tables. Do not use this web page for clinical purposes. The author makes no assertion about their accuracy, and will not assume any liability.

 
Strabismus surgery dosage:

 

EXODEVIATION:

 

MONOCULAR RECESS-RESECT PROCEDURES FOR EXODEVIATION:

 

Exotropia         Recess LR        AND    Resect MR

(diopters)         (mm)                            (mm)

15                    4                                  3

20                    4 to 5                           4

25                    6                                  4.5 to 5

30                    6.5 to 7                        5 to 6

35                    7.5                               5.5

40                    8                                  6

50                    9                                  6 to 7

60                    10                                6 to 8

70                    10                                7 to 9

80                    10                                10

 

 

SYMMETRICAL SURGERY FOR EXODEVIATION:

 

Exotropia         Recess LR     OR         Resect MR OU

(diopters)         (mm)                            (mm)

15                    4 to 4.5                        3

20                    5 to 5.5                        4

25                    6                                  4.5 to 5

30                    7                                  5 to 6

35                    8                                  5.5

40                    8 to 9                           6

45                    9.5

50                    10

 
FOUR-MUSCLE SYMMETRICAL SURGERY FOR EXODEVIATION:
(Four muscle surgery table from:  Parks MM and DelMonte, in Duane TD (editor), Clinical Ophthalmology 1991:
 
Exotropia        Recess LR    AND    Resect MR OU.
(diopters)        (mm)                        (mm)
50                    6                                5
60                    7                                6
70                    7.5                            6.5
80                    8                                7
 

 

 

SYMMETRICAL SURGERY FOR ESODEVIATION:

 

Esotropia          Recess MR  OR           Resect LR OU

(diopters)         (mm)                            (mm)

15                    3                                  3.5 to 4

20                    3.5 to 4                        4.5 to 5

25                    4 to 4.5                        5.5 to 6

30                    4.5 to 5                        6 to 7

35                    5 to 5.5                        6.5 to 8

40                    5.5 to 6                        7.5 to 9

50                    6 to 7                           9

 

 

 

MONOCULAR RECESS-RESECT PROCEDURES FOR ESODEVIATION:

 

Esotropia          Recess MR      AND    Resect LR

(diopters)         (mm)                            (mm)

15                    3                                  4

20                    3.5                               4.5 to 5

25                    4 to 4.5                        5 to 6

30                    4.5 to 5                        5.5 to 7

35                    5 to 5.5                        6.5 to 8

40                    5.5 to 6                        7.5 to 9

45                    6                                  8

50                    6                                  9

 

 

 

HYPERTROPIA:

 

                        Operating on:

                        Ipsilateral                                  Contralateral

                        (Hypertropic) Eye                     (Hypotropic) Eye

Hypertropia      SR recess         IR Resect         SR Resect        IR Recess

(PD)                 (mm)                (mm)                (mm)                (mm)

5                      3                                                                      3

10                    4                                                                      4

15                    5                                                                      5

20                    6.5                                           3                      5

25                    5                      5                      5                      6

30                    6                      5                      6                      6

 

 

DISSOCIATED VERTICAL DEVIATION OF BOTH EYES:

 

      DVD                    SR recession

     (PD)                        (mm)

     <10                        6
       10                          7
      15                                   8
      20                                    9

25                          10

 

Sources: 

1.  American Academy of Ophthalmology Basic Science Course. (Plain text).

2. Rosenbaum AL, Santiago AP.  Clinical Strabismus Management: principles and surgical techniques.  1999.  W. B Saunders. Philadelphia. (Italicized figures).

 

 

11-03-04.